QRS Fragmentation: A Predictor of Mortality in Patients with Cardiovascular Diseases

Emerging research has highlighted the significance of fragmented QRS (fQRS), a notable marker on the electrocardiogram (ECG), in various cardiovascular diseases (CVDs). In this retrospective cohort study, we aimed to investigate the MASHAD study population regarding the presence of fQRS and its association with the incidence of subsequent CVDs, including coronary artery disease (CAD) and cerebrovascular event (CVA). A total of 8,834 individuals with available and interpretable ECGs and without a confirmed CVD at baseline were classified into the fQRS group (N = 146) and the non-fQRS group (N = 8,688). After a ten-year follow-up, CVD developed in 18 subjects from the fQRS group and 924 from the non-fQRS group. The mortality rates were 6 and 149 individuals in the fQRS and non-fQRS groups, respectively. Statistical analyses indicated a significant association between fQRS and the mortality from CVD and CAD (p = 0.029 and 0.023), but not CVA (p = 0.606). Furthermore, Kaplan-Meier survival analysis was performed to evaluate the prognostic significance of fQRS on the CVD-related and CAD-related mortality. We concluded that the presence of fQRS in ECG significantly influences a patient's prognosis and could serve as a predictor for mortality among CVD patients.